| NPI | 1508153529 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MITZI MCKOOL GADWELL Counselor 505-323-3860 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NM 0139921) |
| Enumeration Date | 2011-06-29 |
| Last Update Date | 2011-06-30 |